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Abstract
Hearing impairment among school-aged children in the developing world has been widely reported as a significant health problem (Rao et al., 2002). However, early detection of hearing loss in the developing countries poses significant practical challenges, and the identification of hearing loss by routine school screening is still uncommon (Olusanya et al., 2004 This study was conducted in an urban and rural school in Shebin El-Kom city and district. The aim was to examine prevalence and causes of hearing impairment among Egyptian primary school students. Another aim was to conduct a hearing education program for teachers and parents of the hearing impaired children. The students were screened at their schools for HI and positive cases were referred for diagnostic assessment Risk factors were investigated through a parent questionnaire and environmental study that included assessment of the ventilation and crowding status in both schools, measurement of noise levels and measurement of the ambient lead concentration A hearing education program was conducted for parents of cases and for teachers in the schools. The program included topics about early detection and detection of hearing impairment in children, how to prevent the disease and how to communicate with children with hearing impairment. The knowledge and attitude of parents and teachers were evaluated to determine the effectiveness of the training program The prevalence of hearing impairment among primary school students was 21%. The most common type of hearing loss was conductive of minimal to mild severity.Risk factors significantly associated with hearing impairment in the children were; birth order 3, socio-economic status, consanguinity,house-hold smoker, family history, Toxoplasma, drug misuse in pregnancy, underweight, jaundice, type of feeding, measles and chronic otitis media. Atmospheric lead concentrations were 0.14ug/m3 in the rural area and 0.21ug/m3 in the urban area. Crowding indices, ventilation indices and noise levels in both schools were below the standard levels. Multivariate logistic regression revealed that the most important predictors for HI in the children were parent suspicion of hearing impairment, chronic otitis media, presence of a smoker in the house, neonatal jaundice, pregnancy medication, Toxoplasma infection and socio-economic status.